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Regional disparities in botulinum toxin A (BoNT-A) therapy for spasticity in Sweden: budgetary consequences of closing the estimated treatment gap
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.ORCID iD: 0000-0001-6464-9130
Ipsen, Sweden.
Nordic Health Econ AB, Sweden.
2017 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 135, no 3, 366-372 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: As no national treatment guidelines for spasticity have been issued in Sweden, different regional treatment practices may potentially occur. This study examines botulinum toxin A (BoNT-A) treatment for spasticity on a regional level in Sweden and presents budgetary consequences of closing the estimated treatment gap. Materials and Methods: Prevalence of spasticity in Sweden was estimated from published data. Regional sales data for BoNT-A were acquired from IMS Health. A set proportion of hospital BoNT-A use was assumed to represent treatment of spasticity. Total intervention cost of BoNT-A treatment was gathered from healthcare regional tariffs, while costs associated with spasticity were derived from publications on multiple sclerosis and stroke. Results: Results show that the regional variation in treatment of spasticity with BoNT-A is large, with approximately every fourth patient being treated in Southern healthcare region compared to every tenth in the Stockholm-Gotland or Western healthcare regions. The incremental cost of filling the reported treatment gap was also assessed and was estimated at around 9.4 million EUR. However, for the incremental cost to be offset by savings in spasticity-related costs, only a small proportion of treatment responders (defined as patients transitioning to a lower severity grade of spasticity) was required (12%). Conclusions: The study revealed apparent regional disparities of BoNT-A treatment for spasticity in Sweden. The results further suggest that the incremental cost of eliminating the treatment gap has a high probability of being offset by savings in direct costs, even at a low proportion of the patients reaching clinical improvement.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 135, no 3, 366-372 p.
Keyword [en]
botulinum toxins; costs and cost analysis; muscle spasticity; regional variation
National Category
Neurology
Identifiers
URN: urn:nbn:se:liu:diva-136626DOI: 10.1111/ane.12610ISI: 000397285600014PubMedID: 27220381OAI: oai:DiVA.org:liu-136626DiVA: diva2:1089872
Note

Funding Agencies|University of Linkoping

Available from: 2017-04-21 Created: 2017-04-21 Last updated: 2017-04-21

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CiteExportLink to record
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Citation style
  • apa
  • harvard1
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